Catheter-based ablation of nerves in the adventitia of renal arteries (renal artery
denervation [RAD]) using radiofrequency energy can reduce blood pressure (BP) in patients
with resistant arterial hypertension (RAH). Occurrence of renal artery stenosis after
RAD is still an important concern. We systematically investigated the renal artery
anatomy using magnetic resonance imaging (MRI) or computed tomography (CT) angiography
in a consecutive series of patients 6 months after RAD. Patients with RAH were treated
by RAD after exclusion of secondary causes of hypertension. RAH was defined by a mean
systolic office BP >160 mm Hg. Renal artery imaging was performed 6 months after RAD
by MRI angiography. In case of any contraindication for MRI, a CT angiography was
performed. The primary end point was the incidence of significant renal artery stenosis
(≥70% lumen diameter reduction). RAD was performed in 76 patients, and evaluation
of renal artery anatomy by MRI (n = 66; 87%) or CT angiography (n = 10; 13%) was performed
in all patients 6 months after RAD. We found no renal artery stenosis but 2 cases
of new nonsignificant stenosis (50% TO 69% lumen diameter reduction). In responders,
mean systolic office BP reduction was −30 mm Hg (p <0.001) and mean systolic 24-hour
BP reduction was −18 mm Hg (p <0.001). In conclusion, the incidence of significant
renal artery stenosis 6 months after RAD seems to be very low. However, late-onset
development of nonsignificant renal artery narrowing cannot be excluded in some patients
and should be anticipated in the case of RAH relapse or worsening of renal function
after successful RAD.
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Article Info
Publication History
Published online: March 14, 2015
Accepted:
February 26,
2015
Received in revised form:
February 26,
2015
Received:
December 23,
2014
Footnotes
See page 1548 for disclosure information.
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
